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Scope Treatment of a Ureterocele in the Bladder

South Carolina rates for HCPCS 52301

A thin telescope is passed along the urine channel into the bladder, and a ureterocele — a balloon-like swelling at the end of the tube bringing urine down from the kidney — is cut open or destroyed so urine can drain freely. It is done entirely through the natural opening, with no external incision.

Rates data updated July 2026.

Facilitymedian $8,913 · 10th–90th $355$21,3800%5%10%10th90th$8,913Professionalmedian $355 · 10th–90th $282$5620%20%10th90th$355$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$11,748.98
Typical High
$22,908.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$346.74
Typical High
$398.11
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,691.53
Median
$6,760.83
Typical High
$11,220.18
BCBS
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$467.74
Typical High
$707.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$2,089.30
Typical High
$2,691.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$398.11
Typical High
$741.31
Medcost
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$426.58
Typical High
$676.08
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$2,754.23
Median
$10,715.19
Typical High
$16,982.44
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$354.81
Typical High
$602.56